Healing Power of Music

 Music and Dementia

“Most people are just awed by the power of music to awaken a person with Alzheimer's disease,” says music therapist Al Bumanis, a spokesman for the American Music Therapy Association in Silver Spring, Maryland. Many dementia patients who can no longer speak or recognize faces show a heartening—and startling—response to “their kind of music.” They sing along with the melody. Or, if they don't sing, they mouth the words. “The reawakening of the connection between patient and caregiver when they’re singing together can be very moving,” Bumanis says.

“It is well established that music is a very important tool in reaching people with dementia—even in the advanced stage,” points out Jed Levine, director of programs for the New York City chapter of the Alzheimer's Association. “There is evidence that the ability to hear and the ‘center for music’ remain active. At all stages of the disease, music can provide stimulation as well as solace and comfort.”

To break through to someone locked in dementia, Levine points out, a friend or caregiver must choose melodies that have particular significance for that person. The music that resonates most strongly for most of us, notes Dr. Tomaino (Above, Dr. Tomaino sings with dementia patients earlier in her career at Beth Abraham), is the music we heard as teenagers—although “classical-music fanatics” respond most fervently to a particular opera or the work of a particular composer.

A 2001 study at McGill University clarified just how exquisitely particular musical taste can be. Ten classical musicians claimed that their favorite piece of music sent chills down their spine. This is quite likely, since music—like sex, cocaine, and other abused drugs, and food—triggers the area of the brain that releases dopamine, a neurotransmitter associated with feelings of pleasure and reward. The McGill researchers were intrigued: Would musicians get spine-shivers from other people’s favorite classical pieces? Would these “control” pieces trigger the pleasurable responses signified by changes in cerebral blood flow with the same intensity of emotion and arousal? Would they, too, spark what neuroscientist Daniel Levitin calls “goosebumps on the brain”?

The answer was “no.” The participants found spine-tingling pleasure only in their favorite pieces. The moral: If musical taste is this selective, then it’s clear that a melody will stir or comfort or stimulate a patient with dementia—indeed, any patient—BUT only if it’s his kind of music.

Harnessing Music’s Restorative Power

There are many ways to bring the pleasures of music to hospitalized or homebound friends or family members—whether or not you’re the sort who’s comfortable launching into a song at bedside.

Bring in a playlist of songs customized by a specialist to strike the strongest emotional chord. The Institute for Music and Neurologic Function’s Well Tuned: Music Players for Health program (a collaboration with another nonprofit, Music & Memory) can help you discover which songs will resonate with a patient. A licensed musical therapist will consult you by phone about the patient’s musical taste, then load an MP3 or iPod with a customized playlist of therapeutic music. (Playlists can be created for individuals with Alzheimer’s disease and other forms of dementia; Parkinson’s disease; depression; or anxiety.) For details and fees, visit their website. To donate your working iPod or MP3 player (with cable or dock) for this purpose, call the institute’s Well-Tuned program at 718 519-5840.

Many sick or elderly patients are too agitated to put on headphones or keep earbuds in their ears. The Well Tuned program’s specialist can suggest alternative speaker options or iPod docks; indeed, there’s even a “pillow speaker” (a pillowcase safely wired with headphones), which the patient can use if the hospital staff gives permission.

Use music to reach the dying. Asked about music’s ability to provide comfort at the end of life, Tomaino says fervently, “It’s a boon to all the family members. It helps with pain and stress, helps the patient feel at peace. And if she’s alert, it can help her with life transition issues—help her say to her loved ones what she wants to say.

“Family members often say to me, ‘I go into the room, and don’t know what to say. It’s so stressful and awkward; I take the kids, and what do we do?” I tell them, ‘Take the kids and help them choose music that will help them express what they want to express.” A music therapist can help with this—help family members pick the music that says what they want to say. Even if the patient is minimally responsive, he will experience, through music, that family members are conveying emotion to him.

Sing to the patient, Dr. Tomaino urges. “Many say they can’t sing, but if they do it as a group, there’s usually no problem. And when they do choose a song, it’s usually something that’s very poignant. More times than not, the family members are very grateful for being able to have that experience.”

Call in a music therapist. When the patient’s suffering is acute—when he or she urgently needs a respite from pain, agitation, depression, isolation—consider calling on a licensed music therapist to kindle the release from anxiety and the surge of endorphins that music bestows. There may be such a professional on the hospital’s staff; if not, you can locate one through the American Music Therapy Association (AMTA). In New York City the hourly fee ranges from about $60 to about $95. Some music-therapy treatments are reimbursable through Medicare, Medicaid, or private insurance; see the FAQ page on the AMTA’s website for details.

Recently, the Institute for Music and Neurologic Function inaugurated a program offering private sessions in the patient’s home or medical facility through its Music Therapy Professionals Practice. The IMNF’s music therapists work with patients in many different areas: memory enhancement, movement and speech rehabilitation after traumatic brain injury, pain management, early-childhood intervention, medical psychotherapy (aid in dealing with the stresses involved with serious illness)—and they’ll also train caregivers in how to use therapeutic music to help their loved ones. In New York City the hourly fee ranges from about $60 to $100 for a 45-minute session.

For caregivers, too, music has restorative power. Singing in a chorus, after all, triggers the brain to release the “pleasure and reward” chemical, dopamine. So does a night at the Philharmonic, at a jazz club, in an Irish pub...wherever you’ll find the sort of music—sublime, sacred, plaintive, effervescent—that resonates with you. 

Deborah Harkins, an editor at Women's Voices for Change, was an assigning editor at New York magazine for more than 20 years, the articles editor of The Modern Estate, a columnist for The New York Daily News, and associate editor at NYCitywoman.com.